Use Stedi to exchange the following transactions with Medicaid Pennsylvania using APIs or SFTP. Send transactions as JSON or raw EDI files.
Eligibility & benefit verification
Supported
Eligibility checks
(270/271)
Verify member coverage and benefits by sending real-time and batch eligibility checks to Medicaid Pennsylvania.
Not supported
Coordination of benefits checks
(COB)
Submit coordination of benefit checks to Medicaid Pennsylvania to determine if a member has overlapping coverage with another plan and determine each payer's responsibility for paying claims.
Claims processing
Not supported
Real-time claim status
(276/277)
Check on the status of a claim previously submitted to Medicaid Pennsylvania in real-time by sending a claim status check (276/277).
Supported
Professional claims
(837P)
Submit professional claims to Medicaid Pennsylvania and receive 277 claim acknowledgments asynchronously.
Supported
Institutional claims
(837I)
Submit institutional claims to Medicaid Pennsylvania and receive 277 claim acknowledgments asynchronously.
Supported, enrollment required
Claim payments
(835 ERA)
Receive electronic remittance advice (ERAs) from Medicaid Pennsylvania to review full payment details.
Supported
Dental claims
(837D)
Submit dental claims to Medicaid Pennsylvania and receive 277 claim acknowledgments asynchronously.
Not supported
Unsolicited claim attachments
(275)
Receive unsolicited attachments for claims submitted to Medicaid Pennsylvania.
Get started
Use Stedi's APIs to get fast and reliable connectivity to Medicaid Pennsylvania and start processing healthcare claims and eligibility checks within minutes.
Start processing healthcare claims and eligibility checks with Stedi and Medicaid Pennsylvania today.